Valentini G, Forlani S, Zompatori M, Longi R
Servizio TAC, Ospedale "Infermi", USL 40 Rimini Nord.
Radiol Med. 1993 Dec;86(6):820-5.
Twenty-five HIV-negative patients with proven tuberculosis were studied; 10 of them had had bacteriologic confirmation, 1 tuberculin conversion, 2 biopsy confirmation and in 12 cases ex juvantibus criteria had been followed. All patients underwent X-ray and CT exams of the chest which were useful for diagnosis, prognosis and treatment in 22/25 patients. CT yielded better results than conventional radiography in the following cases: miliary cases (1 CT-positive case vs no positives at conventional X-rays), cavities (12 CT-positive cases vs 6 at conventional X-rays), bronchogenic spread (10 CT-positive cases vs 7 at conventional X-ray), nodules (4 CT-positive cases vs 2 at conventional X-rays), consolidations (5 CT-positive cases vs 1 at conventional X-rays), adenopathies (10 CT-positive cases vs 7 at conventional X-ray), extrapulmonary lesions (3 CT-positive cases vs no case at conventional X-ray). In 13 patients with negative sputum CT helped the diagnosis to be made. Chest radiography is currently the major exam for the first approach to tuberculosis. Nonetheless, CT yields valuable information when clinical signs or bacteriologic information are poor.
对25例确诊为结核病的HIV阴性患者进行了研究;其中10例有细菌学确诊,1例结核菌素阳转,2例经活检确诊,12例依据治疗反应标准确诊。所有患者均接受了胸部X线和CT检查,这些检查对22/25例患者的诊断、预后和治疗有帮助。在以下情况中,CT比传统X线摄影效果更好:粟粒型病例(CT阳性1例,传统X线检查无阳性)、空洞(CT阳性12例,传统X线检查6例)、支气管播散(CT阳性10例,传统X线检查7例)、结节(CT阳性4例,传统X线检查2例)、实变(CT阳性5例,传统X线检查1例)、淋巴结肿大(CT阳性10例,传统X线检查7例)、肺外病变(CT阳性3例,传统X线检查无阳性)。在13例痰检阴性的患者中,CT有助于做出诊断。胸部X线摄影目前是结核病初诊的主要检查方法。尽管如此,当临床体征或细菌学信息不充分时,CT能提供有价值的信息。